日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

A 42-year-old male patient visited our hospital with complaints of decreased motivation and weakness. Brain magnetic resonance imaging (MRI) revealed abnormalities in the right frontal lobe. Based on brain MRI findings, neurosyphilis and herpes encephalitis were suspected. Blood and spinal fluid analysis showed elevated TPLA and RPR levels, leading to the diagnosis of neurosyphilis. There was no evidence of syphilis infection in the penis or skin. Serum TPLA and RPR levels decreased after treatment with penicillin G and amoxicillin. Non-symptomatic progressive neurosyphilis is rare and may become irreversible by the time it is diagnosed.